Frère Ariane, Caspers Laure, Makhoul Dorine, Judice Lia, Postelmans Laurence, Janssens Xavier, Lefebvre Pierre, Mélot Christian, Willermain François
1 Department of Ophthalmology, CHU Saint-Pierre, Université Libre de Bruxelles , Brussels, Belgium .
2 Department of Ophthalmology, CHU Brugmann, Université Libre de Bruxelles , Brussels, Belgium .
J Ocul Pharmacol Ther. 2017 May;33(4):290-297. doi: 10.1089/jop.2016.0139.
To investigate the effect of a single intravitreal dexamethasone implant (IVT-DI; Ozurdex; Allergan, Inc.) on visual acuity, macular thickness, and intraocular pressure (IOP) in active noninfectious uveitis.
Medical records of patients with noninfectious active uveitis treated by IVT-DIs were retrospectively reviewed. Uveitis etiologies, treatment indications, best corrected visual acuity (BCVA), central retinal thickness measured by ocular coherence tomography, IOP, and systemic, local, and topical treatments were collected. Parameters were analyzed before the injection of the implant, after 1.5 ± 0.8 months and 4.4 ± 0.9 months for the BCVA, after 2 ± 1.3 months and 4.6 ± 1.3 months for the ocular coherence tomography, and after 1.3 ± 0.7 months and 4.4 ± 1 months for the IOP.
We included 14 patients (20 eyes, 20 implant injections) with cystoid macular edema (78%), vasculitis (7%), choroiditis (7%), and vasculitis associated with choroiditis (7%). Before the injection, mean visual acuity was 0.4 ± 0.5 logMAR (logarithm of the minimum angle of resolution) that improved to 0.3 ± 0.5 logMAR (P = 0.0002) after 1.5 ± 0.8 months and to 0.3 ± 0.5 logMAR (P = 0.005) after 4.4 ± 0.9 months. A statistically significant decrease of macular thickness was observed both at 2 ± 1.3 months and at 4.6 ± 1.3 months after IVT-DI. Mean IOP was 16 ± 5 mmHg before injections, 18 ± 6 mmHg (P = 0.13) at 1.3 ± 0.7 months, and 15 ± 4 mmHg (P = 0.65) at 4.4 ± 1 months. By Kaplan-Meier analysis, we found that after 3.3 months, 17% of the eyes still present a BCVA amelioration ≥0.3 logMAR.
In our patients with active noninfectious uveitis, injection of a first single dexamethasone implant was found to improve visual acuity and decrease macular thickness without significant increase of IOP, although the effect seems limited in time.
研究单次玻璃体内注射地塞米松植入物（IVT-DI；Ozurdex；艾尔建公司）对活动性非感染性葡萄膜炎患者视力、黄斑厚度和眼压（IOP）的影响。
回顾性分析接受IVT-DI治疗的非感染性活动性葡萄膜炎患者的病历。收集葡萄膜炎病因、治疗指征、最佳矫正视力（BCVA）、经光学相干断层扫描测量的中心视网膜厚度、IOP以及全身、局部和局部治疗情况。在植入物注射前、BCVA在注射后1.5±0.8个月和4.4±0.9个月、光学相干断层扫描在注射后2±1.3个月和4.6±1.3个月、IOP在注射后1.3±0.7个月和4.4±1个月时对参数进行分析。
我们纳入了14例患者（20只眼，20次植入物注射），其中黄斑囊样水肿患者占78%，血管炎患者占7%，脉络膜炎患者占7%，血管炎合并脉络膜炎患者占7%。注射前平均视力为0.4±0.5 logMAR（最小分辨角对数），在1.5±0.8个月后提高到0.3±0.5 logMAR（P = 0.0002），在4.4±0.9个月后提高到0.3±0.5 logMAR（P = 0.005）。在IVT-DI注射后2±1.3个月和4.6±1.3个月时均观察到黄斑厚度有统计学意义的下降。注射前平均IOP为16±5 mmHg，在1.3±0.7个月时为18±6 mmHg（P = 0.13），在4.4±1个月时为15±4 mmHg（P = 0.65）。通过Kaplan-Meier分析，我们发现3.3个月后，17%的眼睛BCVA改善仍≥0.3 logMAR。
在我们的活动性非感染性葡萄膜炎患者中，首次单次注射地塞米松植入物可提高视力并降低黄斑厚度，且IOP无显著升高，尽管这种效果似乎在时间上有限。
